Breast Cancer Investigations

Once you have been diagnosed to have breast cancer from the tissue biopsy, you will be advised for more tests to check if the cancer has spread to other areas and organs. Depending on the clinical presentation of the breast cancer, your surgeon or oncologist will advise the appropriate investigation necessary.

Blood Tests
CT scan whole body (Computerised Tomography)
PET-CT Scan whole body (Positron Emission Tomography)
Bone Scan
Breast MRI
Oncotype-Dx Test
IHC Tests (Immunohistochemistry)

Blood Tests

General Blood test

Full Blood count, Renal Profile, Liver Function Test

Blood Tumour Markers

Serum Ca 15.3 - for breast and ovarian cancers
Serum 125 - for ovarian cancer, breast cancer recurrence and ovarian cancer recurrence
Serum CEA (carinoembryonic antigen) – for colon, lung or liver cancer and if extensive cancer has spread to other areas of body

Imaging

CT Scan whole body (Computerised Tomosynthesis)

It is a computed scan using radiation contrast to take detailed pictures of the whole body from head to pelvis. A whole body scan is recommended as breast cancer can spread commonly to the brain, lung, liver, bone and adrenal gland.

PET /CT Scan (Positron Emission Tomography)

A special radioactive sugar is injected into the vein and travels throughout the body. Cancer cells will absorb the high amount of radioactive sugar and scan picture taken will show where the cancer is collected. It is a very expensive investigation but sensitive to detect cancer cells

Breast MRI (Magnetic Resonance Imaging)

Breast MRI is an imaging that uses radiowaves and strong magnets to view soft tissue and structure of the breast better. It is costly and therefore not recommended for regular breast examination or screening.

It is indicated for the following cases

women who are at high risk for breast cancer
women with possible small cancers in a dense breasts
women who have previous injection of fillers into the breasts

False positive findings are high which means more likely to find something that turns out not to be a cancer.

Bone Scan

This scan is similar to PET scan but uses a different radioactive substance that settles in the bone where plain bone xray will not be able to see. It is not necessary if PET /CT whole body has been done.

Brain MRI

Sometimes when brain metastasis are found on CT scan images, you will be recommended to perform Brain MRI to get a more detailed image of the number of brain metastases for treatment.

Chest X-Rays

This is a simple X ray of the lungs to see if the cancer has spread to the lungs. It is often performed as a routine surveillance check up after initial treatment

Ultrasound of Abdomen and Pelvis

Ultrasonography of the solid organs like liver, kidneys, Spleen, Adrenals, Ascites, Uterus and Ovaries. Breast Cancer can metastasize to the solid organs and this will be used to assess during surveillance check up after treatment.